Tocilizumab in COVID-19 interstitial pneumonia.
J Intern Med
; 289(5): 738-746, 2021 05.
Article
em En
| MEDLINE
| ID: mdl-33511686
BACKGROUND: Published reports on tocilizumab in COVID-19 pneumonitis show conflicting results due to weak designs or heterogeneity in critical methodological issues. METHODS: This open-label trial, structured according to Simon's optimal design, aims to identify factors predicting which patients could benefit from anti-IL6 strategies and to enhance the design of unequivocal and reliable future randomized trials. A total of 46 patients with COVID-19 pneumonia needing of oxygen therapy to maintain SO2 > 93% and with recent worsening of lung function received a single infusion of tocilizumab. Clinical and biological markers were measured to test their predictive values. Primary end point was early and sustained clinical response. RESULTS: Twenty-one patients fulfilled pre-defined response criteria. Lower levels of IL-6 at 24 h after tocilizumab infusion (P = 0.049) and higher baseline values of PaO2/FiO2 (P = 0.008) predicted a favourable response. CONCLUSIONS: Objective clinical response rate overcame the pre-defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in patients selected according to our inclusion criteria warrants investigations in randomized trials.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pneumonia Viral
/
Interleucina-6
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Monitoramento de Medicamentos
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Biomarcadores Farmacológicos
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Anticorpos Monoclonais Humanizados
/
COVID-19
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
Limite:
Aged
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Female
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Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Intern Med
Assunto da revista:
MEDICINA INTERNA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Itália